Health Issues and Immunological Assessment Related to Wuhan's COVID-19 Survivors: A Multicenter Follow-Up Study

Frontiers in Medicine

Qing Zhang¹  Lingjie Zhang²  Amy Bryant³  Li Wei⁴  Fei Wang⁴  Suihuai Guo⁵  Xianglin Yuan⁶  Guangyuan Hu⁶  Qi Mei⁶  Yang Yang⁷  Jian Li⁸  Christian Kurts⁸ 

[1] Covid-19 Rehabilitation Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China;Department of Anesthesiology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China;Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, Idaho State University, Meridian, ID, United States;Department of Chinese Medicine, Wuhan No.1 Hospital, Huazhong University of Science and Technology, Wuhan, China;Department of Intensive Care Unit, Wuhan Wuchang Hospital, Wuhan, China;Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China;Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China;Institute of Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, Bonn, Germany;

关键词: post-COVID-19;    SARS-CoV-2;    mortality;    hospital discharge;    post-COVID-19 sequela;    physical and psychological symptoms;   

DOI  :  10.3389/fmed.2021.617689

来源: DOAJ

【 摘 要 】

Background: Currently, a large number of hospitalized coronavirus infectious disease-2019 (COVID-19) patients have met the clinical discharge criteria and have been discharged. Little is known about the sequelae and herd immunity, two important factors influencing the life quality and safety of COVID-19 survivors.Methods: Discharged COVID-19 patients from four medical facilities in Wuhan, China, were followed in order to record and investigate possible post-COVID-19 sequelae and herd immunity. After hospital discharge, patients reported to Fangcang shelter hospitals for an initial 14-day period of mandatory clinical monitoring. After release from these shelter hospitals, patients returned home for self-quarantine. Real-time quantitative PCR (RT-qPCR) was used for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) detection. Colloidal gold-based immunochromatographic strip assay (ICGSA) was used for anti-SARS-CoV-2 immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody testing. The data for this study are derived from case reports, medical records, and self-reports.Results: A total of 3,677 COVID-19 survivors [median age = 59 years, interquartile range (IQR) = 47–68, range = 10–98; 55.5% female] who were released from four hospitals in Wuhan, China, between January 18 and March 29, 2020 were followed for a median of 144 days (IQR = 135–157). During follow-up, 976 (26.5%) patients had at least one post-COVID-19 sequela. The incidence of post-COVID-19 sequelae among elderly COVID-19 survivors (age ≥60 years) was slightly increased compared to that of young COVID-19 survivors (age <60 years; relative risk = 1.05, 95% CI = 1.02–1.10, p = 0.007). During follow-up, a dramatic reduction of anti-SARS-CoV-2 IgG (88.0%, 95% CI = 84.2–90.4) and IgM (93.2%, 95% CI = 88.5–96.4) antibodies was observed. Among these COVID-19 survivors, 1.2% (n = 45) retested positive for SARS-CoV-2 and 1.0% (n = 37) died during follow-up. Of those who died during follow-up, 70.3% were male and all were negative for both IgG and IgM, except for one person who was IgG-positive.Conclusions: Our study documents significant post-COVID-19 sequelae that impair functions of multiple organ systems in COVID-19 survivors, suggesting that the long-term effects of this disease will negatively impact survivors' quality of life, continue to strain health care systems, and result in extended periods of lost productivity. Furthermore, female gender and anti-SARS-CoV-2 immunity may play an essential role in the survival after COVID-19 infection.

【 授权许可】

Unknown